Prognostic factors for patients with esophageal cancer who achieve pathological complete response in the primary tumor after upfront chemotherapy or chemoradiotherapy

IF 2.9 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Masaaki Motoori, Koji Tanaka, Hiroshi Miyata, Makoto Yamasaki, Osamu Shiraishi, Atsushi Takeno, Tomoki Makino, Keijiro Sugimura, Takushi Yasuda, Yuichiro Doki
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引用次数: 0

Abstract

Aim

Upfront chemotherapy (uCT) or upfront chemoradiotherapy (uCRT) followed by surgery is generally accepted as the standard treatment for patients with locally advanced esophageal cancer. A substantial proportion of patients achieve a pathological complete response (pCR) of the primary tumor with upfront treatment. This retrospective study aimed to clarify the prognostic factors of patients with esophageal cancer who achieve pCR in the primary tumor after upfront treatment and whether the prognosis of patients with pCR who receive uCT differs from that of patients who receive uCRT.

Methods

This study included 121 patients who achieved pCR of the primary tumor after uCT and 40 patients after uCRT. Univariate and multivariate survival analyses were performed.

Results

Multivariate analysis of overall survival demonstrated that gender, upfront treatment, and pathological lymph node metastasis were independent prognostic factors (p = 0.0086, 0.011, and 0.031, respectively). Multivariate analysis of relapse-free survival demonstrated that gender, cM status, and pathological lymph node metastasis were independent prognostic factors (p = 0.033, 0.014, and 0.0010, respectively). Among patients without pathological lymph node metastasis, the uCT group showed significantly better both overall and relapse-free survival than the uCRT group (p = 0.014 and 0.037, respectively). Recurrence occurred in 24 patients in the uCT group and 9 in the uCRT group. All of local treatment (chemoradiotherapy and surgery) for recurrent lesions was performed in the uCT group.

Conclusions

Male genders and pathological lymph node metastasis are independent poor prognostic factors in patients with esophageal cancer who receive upfront treatment followed by surgery and achieved pCR of the primary tumor.

Abstract Image

食管癌患者经前期化疗或放化疗后原发肿瘤达到病理完全缓解的预后因素
目的术前化疗(uCT)或术前放化疗(uCRT)加手术是局部晚期食管癌患者普遍接受的标准治疗方法。相当比例的患者通过前期治疗达到原发肿瘤的病理完全缓解(pCR)。本回顾性研究旨在阐明食管癌患者在前期治疗后原发肿瘤达到pCR的预后因素,以及pCR患者接受uCT与接受uCRT患者的预后是否存在差异。方法本研究纳入121例uCT术后原发肿瘤pCR阳性患者和40例uCRT术后原发肿瘤pCR阳性患者。进行单因素和多因素生存分析。结果对总生存率的多因素分析显示,性别、前期治疗和病理性淋巴结转移是独立的预后因素(p分别为0.0086、0.011和0.031)。无复发生存率的多因素分析显示,性别、cM状态和病理性淋巴结转移是独立的预后因素(p分别= 0.033、0.014和0.0010)。在无病理性淋巴结转移的患者中,uCT组的总生存率和无复发生存率均显著高于uCRT组(p = 0.014, p = 0.037)。uCT组24例复发,uCRT组9例复发。uCT组复发病灶均行局部治疗(放化疗和手术)。结论男性和病理性淋巴结转移是食管癌术前手术后达到原发肿瘤pCR的患者预后不良的独立因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Gastroenterological Surgery
Annals of Gastroenterological Surgery GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.30
自引率
11.10%
发文量
98
审稿时长
11 weeks
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